What is Martin's Point Generations Advantage Value?
Martin's Point Generations Advantage Value is a 2019 Medicare Advantage plan, from Martin's Point Health Care, available in Washington County, Maine.
- It's a Health Maintenance Organization (HMO) health plan.
- It offers the same basic benefits as Original Medicare.
- It may offer extras that Medicare does not cover.
- The maximum out-of-pocket cost with this plan is $5,500 .
- The monthly premium is $0.00 (plus your Part B premium).
- NOTE: It does not include a prescription drug plan (Part D).
Martin's Point Generations Advantage Value vs. Medicare
This HMO plan replaces your Original Medicare coverage. You agree to let Martin's Point Health Care manage your Medicare benefits.
The benefit of an HMO plan is lower, predictable out-of-pocket expenses. Although more restrictive than Original Medicare, a HMO plan limits your annual out-of-pocket costs. With Medicare Parts A and B, there's no cap, leaving you vulnerable to excessive medical bills.
Martin's Point Generations Advantage Value Review
These are the areas of the plan that are important to compare and review:
- Premium: This is the amount you will pay monthly, above and beyond your Medicare Part B.
- Maximum-Out-Of-Pocket (MOOP): This is the most you will pay for co-pays and co-insurance before the plan pays 100%.
- CMS Ratings: Important measurements across 5 different areas that will help you understand how well this plan will care for you.
- Prescription Coverage: Not included with this plan.
- Co-pays & Co-insurance: If you see the doctor regularly, including specialists, you need to know what you'll pay for each visit.
IMPORTANT: With an HMO you are required to use healthcare providers in the plan's network. If you don't you will incur additional costs. Also, be aware that your primary care physician must refer you before you can see a specialist.
NOTE: Martin's Point Generations Advantage Value does not include prescription drug coverage (no drug plan). To get it, you can add one of the stand-alone Medicare Drug Plans in Maine. Prescription drug plans vary widely. Make sure you have the coverage you need.
How Much Does Martin's Point Generations Advantage Value Cost?
The premium on this plan is $0.00 per month. Plus, you must continue to pay your monthly Medicare Part B premium. Co-payments and/or co-insurances also apply with most healthcare services, except preventative care mandated by CMS (see H5591-003 Summary of Benefits below).
IMPORTANT: When evaluating this plan, look past the monthly premium. Identify the costs of the healthcare services you use most. Only then will you uncover the plan's value for your personal situation.
What is the Maximum Out-of-Pocket (MOOP) Limit?
Unlike Original Medicare, Medicare Advantage plans must set an annual Maximum Out-of-Pocket limit on inpatient and outpatient healthcare services. The Martin's Point Generations Advantage Value plan MOOP is $5,500 . Once you reach this amount of spending on your co-payments, all of your Medicare Part A and Part B services will be covered at no additional charge.
Plans can set their MOOP at a voluntary level of $0 to $3,400 (for in-network services) or a mandatory $3,401 to $6,700 (in-network). Combined totals for in-network and out-of-network are generally higher.
NOTE: MOOP does not include what you spend on monthly premiums. It also does not apply to your prescription drugs or Part D deductible.
CRITICAL: It is important to evaluate the combined annual MA/MAPD premiums and MOOP versus what you might expect to pay for a Medicare Supplement in Washington County. Some Medicare Supplements offer less overall financial risk than Medicare Advantage.
Medicare 5-Star Ratings
In this section we show you the quality rating for this Martin's Point Health Care plan. Each year CMS rates health plans (Part C) in five broad categories and drug plans (Part D) in four broad categories. We do not recommend joining a plan with an overall rating less than 3.0. The following marks will give you an idea of the level of care you will receive if you join this health plan.
Does Martin's Point Generations Advantage Value include Medicare Part D?
This plan does not include prescription drug coverage. You can get prescription coverage by joining one of the Medicare Part D Plans in Maine.
How Much are the Copays & Co-Insurance?
In this Summary of Benefits section we outline high-level information about the plan's co-payment and co-insurance costs for inpatient, outpatient, preventive care, transportation and other healthcare services.
Martin's Point Generations Advantage Value vs. Medigap
To compare Martin's Point Generations Advantage Value with a Medigap plan (Medicare supplemental insurance), you need to evaluate your healthcare and financial needs. Look at the total potential cost with each plan type, not just the monthly premium, and choose how you want to use medical care (locally or nationally).
To help you make a better decision, we created our How-to Choose the Best Medicare Plan guide (opens in a new tab). It will help you understand how to compare Martin's Point Generations Advantage Value with Medicare Supplement plans in Maine. Medicare Plan F in Maine is the most popular.
Contact Martin's Point Health Care
For more information about this plan, call their prospective members line, or visit their website:
For assistance 24 hours a day, call 800-633-4227. TTY users should call 877-486-2048. If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov or the Wikipedia page.
Medicare Part C Plan Availability
Martin's Point Generations Advantage Value is available to beneficiaries living in Brookton, Danforth, Lambert Lake, Topsfield, Vanceboro, Waite, Addison, Beals, Calais, Cherryfield, Columbia Falls, Cutler, Dennysville, East Machias, Eastport, Grand Lake Stream, Harrington, Jonesboro, Jonesport, Lubec, Machias, Machiasport, Meddybemps, Milbridge, Pembroke, Perry, Princeton, Robbinston, Steuben, Wesley, Whiting, Baileyville, and all other areas of Washington County, Maine; Medicare plans are the same throughout the County.
The Medicare Advantage plan data on MedicareWire comes directly from CMS.gov and is subject to change. CMS has neither reviewed nor endorsed the information on this site.
The health insurance benefit information provided on this page is a brief summary only, not a complete description. Limitations, co-payments, and restrictions may apply. For more information contact the plan directly at (888)640-4423 or (711)- for TTY users.
The MedicareWire website is available for educational purposes. Our goal is to present information accurately and without bias, based on our interpretation of factual information. However, this site is not intended as a substitute for legal, health, or financial advice from a licensed professional. On this page we help consumers research and compare:
Martin's Point Generations Advantage Value for Washington County, Maine is a 2019 Medicare Advantage Plan (HMO H5591-003), with a $0.00/mo premium and $5,500 max out-of-pocket limit. Compare star ratings, benefits, premiums, co-pays, deductibles and prescription coverage with other Part C plans.
The Martin's Point Health Care logos and brand names used on this page are legal U.S. trademarks. We make no claim to the marks whatsoever, nor do we claim to represent the brands, products or services presented. MedicareWire is a comparison and research website that does not offer Medicare insurance, nor are we compensated for Medicare plan enrollments. We use brand names and logos on this page for editorial purposes, as permitted by U.S. Trademark Fair Use Law.
This Medicare Advantage plan information is maintained by David Bynon and was last updated on .